Bone density in heart or lung transplant recipients--a longitudinal study

Area of Science:

• Transplantation Medicine
• Bone Metabolism
• Immunosuppression

Background:

• Osteoporosis is prevalent in heart or lung transplant (HLT) candidates.
• Bone loss and increased fracture risk are common post-transplant.
• Optimal bone health management in HLT recipients lacks consensus.

Purpose of the Study:

• To report bone health data in HLT recipients before and after transplantation.
• To make recommendations for managing bone health in HLT recipients.

Main Methods:

• Identified HLT recipients (age >20) from the New Zealand HLT Service database (2000-2011).
• Extracted demographic data, immunosuppressive regimens, bisphosphonate use, and serial bone mineral density (BMD).

Main Results:

• Pretransplant osteopenia/osteoporosis prevalence was 23% (heart) and 36% (lung).
• Post-transplant, BMD decreased at the femoral neck in the first year, stabilizing with bisphosphonate use.
• Pretransplant BMD was the major predictor of post-transplant osteopenia/osteoporosis.

Conclusions:

• A significant proportion of HLT recipients have persistent pre- and post-transplant osteopenia or osteoporosis.
• Pretransplant BMD is crucial for risk stratification and targeted intervention.
• Recommendations for bone health management in HLT recipients are provided.